Obstetric kukha mwazi: Zoyambitsa ndi malangizo chithandizo

Mwatsoka, kukha magazi obstetric nthawizonse chimodzi cha zimayambitsa zikuluzikulu za imfa akazi akabereka. N'chifukwa chake ndikofunika kuganiza kuti matendawo mimba kuti akanapereka thandizo woyenera.

obstetric kukha mwazi

Nthawi zambiri woyembekezera, pobereka ndi nyengo ya postpartum, pangakhale mitundu yosiyanasiyana ya mavuto. Mmodzi wa iwo ndi obstetric haemorrhage. Mu matenda achikazi, mawu amatanthauza magazi alionse choopsa thirakiti maliseche kwa lingaliro mochedwa nthawi postnatal.

Malinga ndi kafukufuku, nthawi zambiri zimachitika magazi lachiwiri, trimester lachitatu ndipo pambuyo pobereka. Chifukwa makhalidwe anatomical ndi thupi la akazi kungakhale mofulumira kapena chachikulu obstetric haemorrhage. Pankhaniyi pamafunika riziki yomweyo chithandizo, chifukwa chakuti boma akhoza alanda kwambiri akazi ndi ana.

Gulu la kukha mwazi obstetric

Vuto limeneli ali m'gulu mogwirizana ndi mfundo zosiyana. Obstetrical magazi zifukwa zosiyanasiyana zinayambitsa izo, komanso kukweza kwa magazi otaika. Mwa mavuto omwe m'magulu malinga ndi mfundo yoyamba, tingasiyanitsire magazi zikuchitika:

• mu zoyambirira za mimba;
• mu theka lachiwiri la mimba;
• pa isanayambike ntchito;
• pakati pa ndondomeko generic;
• mu chomaliza;
• akabereka;
• masiku angapo pambuyo pobereka.

Komanso, n'zotheka m'kagulu obstetrical magazi voliyumu ya magazi otaika. Iwo agawidwa mu mitundu monga:

• pachimake magazi imfa;
• chachikulu kutaya magazi syndrome;
• hemorrhagic mantha.

Malinga kuyan'anila alipo ndi kuti, kodi nthawi zidzachitika, osankhidwa njira mankhwala.

Magazi mu trimester mimba

Zimayambitsa chachikulu cha magazi miyezi yochepa yoyambirira ya mimba ndi:

• padera;
• molar mimba;
• mimba khomo lachiberekero;
• khomo lachiberekero kudwala.

Ngati padera mu akazi ankaona kuti zizindikiro zazikulu ululu ndi mavuto aakulu magazi. Ndi kuopseza padera zoonera zazing'ono ndi ululu ali kwina kapena kukometsa kupweteka khalidwe. Mowiriza mimba chidzale kapena chosakwanira. Pamenepa kumadalira kufunika ndi njira kupereka chithandizo.

Komanso, magazi kumachitika pamene vuto monga hydatidiform Mole. kudwala Izi amakhala ndi chakuti villi chorionic akusinthika mu vesicles munali esitirojeni. Pachiopsezo ndi akazi ndi kutukusira kwa ziwalo zoberekera, ndi matenda m'thupi. Chithandizo mu nkhani iyi ndi m'malo ovuta kumadalira mlingo chiwonongeko cha uterine patsekeke.

mimba khomo lachiberekero ndi linasokonekera makamaka kwa masabata 12. Gulu chiopsezo mulinso akazi ndi matenda yotupa, kuvutika wa khomo pachibelekeropo, komanso kuyan'anila za kuzungulira kusamba. N'kofunika kwambiri kwambiri sayenda si dzira mu chiberekero ndi mu ngalande khomo lachiberekero. Magazi Pankhaniyi mokwanira zambiri kuchokera wosweka lalikulu uterine dongosolo mtima.

Tizilombo ting'onoting'ono ngalande khomo lachiberekero angakhalenso chifukwa cha magazi, koma iwo si kanthu. Ndi lalikulu zinamera tizilombo ting'onoting'ono magazi achuluke, choncho n'kofunika thandizo yake mu kukha mwazi obstetric.

zotupa zilonda za chiberekero zimachitika pa mimba ali osowa, monga matenda yodziwika makamaka kwa akazi achikulire kuposa zaka 40. Chithandizo ikuchitika pambuyo pobereka. Ngati nyengo ndi ang'ono, izo zikusonyeza kuchotsedwa kwathunthu kwa chiberekero. Komanso, magazi likhoza kulumikizidwa ndi mimba ectopic. Chifukwa, malo a mwana wosabadwayo mu machubu uterine akhoza kusiya.

Magazi mu theka lachiwiri la mimba

Magazi zingachitikenso lachiwiri ndi lachitatu trimester mimba. zifukwa yaikulu ndi:

• latuluka previa;
• placental abruption;
• uterine chophukacho.

Gulu chiopsezo mulinso akazi amene kale anali akukonza ndi yotupa matenda ndi malformations uterine, komanso hypoplasia wa kumaliseche. Kuphwanya makamaka zimachitika pamene latuluka ndi ili mwachindunji pa khoma kutsogolo kwa chiberekero. Mu theka lachiwiri la mimba ndi chikuchititsa mavuto a magazi angathe kuchizidwa makoma uterine kuswa chifukwa cha kukhalapo kwa chilonda pambuyo opaleshoni, Kaisara gawo kapena kukhalapo hydatidiform Mole. Ngati chotupa uterine, monga ulamuliro, zinthu umatha lethally. Kuwonjezera magazi anati komanso ululu ndithu.

postpartum kukha mwazi

Nthawi zambiri pali obstetrical magazi pobereka ndi oyambirira postnatal nthawi. akazi ambiri yomweyo kuyamba mantha, chifukwa kulingalira momwe boma adzapitiriza, ndipo amaona ponseponse, ndipo zimene zikukhudzana pathologies lapansi. Magazi pobereka zimachitika makamaka chifukwa:

• khomo lachiberekero chophukacho,
• uterine chophukacho,
• PONRP (abruptio placentae).

Chifukwa cha chotupa khomo lachiberekero akhoza kukhala wolemera kwambiri magazi. Izi zimachitika chifukwa chakuti lisaoneke kungakhale m'chipinda chotetezeka ukazi, kapenanso bwanji khoma pansi pa chiberekero. Pachiopsezo ndi akazi ndi kuphwanya ntchito, zipatso lalikulu, komanso kugwiritsa ntchito mankhwala ena. chophukacho khomo lachiberekero angayambe mawonekedwe a magazi kwambiri. Izi makamaka operekera akazi ndi yobereka mofulumira. Matenda lomaliza la dokotala amaika pa anayendera m'njira kubadwa.

Mu gawo loyamba la ntchito kumachitika PONRP kuti amakhala ndi kupweteka kwambiri chiberekero kuti sizigwirizana ndi contractions wa. Pankhaniyi, chiberekero pansi kapena insufficiently omasuka, ndiponso pali lalikulu magazi kuundana. chikhalidwe Izi makamaka anapezeka pa akazi ndi discoordination ntchito, kukhazikitsa mankhwala ena mankhwala, pamaso pa matenda oopsa. Iwo akhoza kukhala yobereka mwamsanga.

Uterine chotupa dokotala oterewa contractions insufficiently amphamvu, pamene akazi kwambiri za ululu. Pankhaniyi, pali amataya magazi kwambiri ku nyini, komanso zotheka yoopsa hypoxia. Pamene ngati umboni wochititsidwa gawo la Kaisara.

Pakhoza kukhala magazi mu obstetric postpartum akuwuka zifukwa monga:

• kovuta kubadwa;
• zipatso zazikulu;
• mimba angapo;
• polyhydramnios.

Magazi kumachitika mu mochedwa nthawi postpartum, nchifukwa chake musanachoke dokotala amakhala bwinobwino amayi kuti akuphwanya ndi kuyan'anila ena, ndipo amavomereza ndi ulemu kwa nthawi ndi makhalidwe a nthawi ya postpartum. Bwinobwino mwachilungamo amphamvu zoonera anati kwa masiku angapo pambuyo pa kubadwa, mpaka nthawi imene zowonongeka mucous minofu ya m'chiberekero chakuwangisa. Aakulu pambuyo partum haemorrhage ndi mavuto owopsa kwambiri zimene zingachititse kuti imfa akuchikazi. Popereka magazi zimadalira kuchuluka kwa magazi otaika. Chotero chikhalidwe amafuna kuwatsitsimula yomweyo.

Zimayambitsa kukha mwazi obstetric

Musanayambe agwire chithandizo, m'pofunika kukhazikitsa chimene chimayambitsa chikwiyire kuswa amenewa. Nthawi zambiri pali obstetric kukha magazi. Thandizo Pankhaniyi zachokera zinthu precipitating kuti nthawi iliyonse mimba ndi ntchito zosiyana. Large magazi imfa kungakhale kowopsa kwambiri kwa mayi ndi mwana wosabadwayo. Mu zoyambirira za magazi mimba uka chifukwa umuna ectopic kapena kutaya mimba. Mu wachiwiri kapena wachitatu trimester magazi kumachitika chifukwa kumaliseche msanga wa latuluka lapansi.

Chapadera magazi nditamaliza ntchito. Panthawi imeneyi, pangakhale mavuto okhudzana ndi mfundo yakuti:

• placental villi kukula mu chiberekero;
• mbali zina za nsengwa akhala mu chiberekero;
• ovulalawo kubadwa ngalande.

Magazi amene amapezeka mu nthawi ya postpartum likhoza kulumikizidwa ndi utachepa uterine kamvekedwe. Komabe, si yafupika, choncho, mwazi sasiya. Zingakhalenso vuto, ndi osauka magazi clotting.

Zizindikiro za kukha mwazi obstetric

Magazi mwina mkati, kunja, kapena osakaniza. magazi kunja zimawonedwa ndi abruption placental ndi dilatation khomo lachiberekero. PONRP kupanga hematoma yodziwika magazi mkati. Tikaphatikiza magazi kumachitika pamene lateral placental abruption ndi kutsegula pang'ono m'njira khomo lachiberekero.

chisamaliro Emergency kwa magazi obstetric ayenera kuperekedwa ngati zizindikiro woyamba, monga:

• magazi ku nyini, kaya kukula ndi chikhalidwe;
• ululu uterine;
• chizungulire, wotumbululuka khungu, kufooka, kukomoka;
• kuchepetsa kuthamanga;
• kusintha kugunda kwa mtima wa mwana wosabadwayo.

Maonekedwe a postpartum haemorrhage chifukwa cha chiwerengero ndi mphamvu ya kutaya magazi. Ngati chiberekero sakulabadira kwa mpheto achire, magazi mu nkhani iyi ili yamphamvu kwambiri ndipo akhoza kufooka wavy khalidwe. Nthawi izo umatsika pansi zochita za mankhwala angapo. Komanso, mkazi ali kwambiri khungu pallor, tachycardia, hypotension.

Voliyumu ya kutaya magazi wa ku 0.5% mwa kulemera kwa mayi oyembekezerayo akuti ndi physiologically yovomerezeka, pamene kukula voliyumu ya kusintha iyi zoipa zimachitika thupi, kotero nkofunika kuthetsa vuto m'njira yake. Mu nthawi ya postpartum, mkazi ayenera kukadziwitsa amphamvu kwambiri ndiponso kwa nthawi yaitali lochia ndi Magulu kwambiri ndipo akukoka ululu pamimba.

mathandizidwe ndi

mankhwalawa obstetrical magazi aligorivimu anapangidwa pambuyo matenda mwatsatanetsatane. Matendawa amayamba ndi kafukufuku mtima kudziwa nthawi ya magazi ndi chikhalidwe. Ndiyeno adokotala atuluka kusonkhanitsa mbiri zachipatala kupeza zimene anali nthendayo wotuluka mimba ndi kubereka.

Pa nthawi yomweyo kuyendera akazi, mogwirizana ndi mtima umagunda mofulumira, kuthamanga kwa magazi, anafufuza chiberekero. Pa nthawi yomweyo tiyenera kulemba mayeso m'chiuno mothandizidwa ndi kalirole, palpation uterine kudziwa mavuto minofu. Mu phunziro zina imachitika ultrasound kuona ngati placental abruption, monga chingwe umbilical ndi chiberekero ngati kukhulupirika wathyoka. Nkofunika kuti amange aligorivimu bwino kwambiri. Obstetric kukha mwazi ndi choopsa kwambiri kwa mayi ndi mwana, kotero muyenera thandizo mwamsanga.

thandizo

Kwenikweni ankafuna kusamaliridwa mwadzidzidzi kwa magazi obstetric, kuyambira ngati chikhalidwe angakhale ovuta ndipo amakwiya mavuto osiyanasiyana. Pamaso pa mkazi magazi kwenikweni anaikidwa kuchipatala kuonetsetsa ndi mankhwala. Mayendedwe ziyenera kuperekedwa kokha mu malo supine. Pankhani ya mimba, ndipo kwambiri kutaika kwa magazi chisamaliro pachimake zikusonyeza kuchotsa hemorrhagic mantha. Mankhwala kutumikiridwa m'nsinga isanafike chikuonetseratu wodwalayo. Pamene kwathunthu anayambitsa mimba zikutanthauza kuti magawowa kuchepetsa chiberekero, kudzera m'mitsempha.

Ngati pali kukha mwazi obstetric, mwadzidzidzi protocol ndi mimba ectopic ikukhudza oyamba mankhwala kuthandiza kuthetsa zizindikiro za hemorrhagic mantha. Komabe, akazi amathera mpweya inhalation. Chithandizo ndi utsogoleli wa glucocorticoids wochititsidwa kokha pamene anasonyeza. Wodwala limasonyeza mwamsanga m'chipatala, mayendedwe a imagwiridwa mu malo mosabvuta. Pa zoyendera anzawo anakhalabe pa 80-100 mamilimita Hg. Art. Ndi amphamvu kwambiri kukha mwazi hospitalization unachitikira resuscitative- timu opaleshoni.

Komanso m'chipatala ikuchitika ndi wotsatira zovuta mankhwala ndi latuluka previa kapena detachment. Onani kuti mavuto ena ndi matenda amene amayambitsa magazi, amafuna dokotala, choncho pakati kwenikweni anavomereza kuchipatala.

Chithandizo cha kukha mwazi obstetric

Aakulu magazi imfa zimachititsa zosiyanasiyana matenda osiyana ndi zosokonezeka. Mankhwalawa kukha mwazi obstetric poyamba ayenera kusiya kutaya magazi ndi kuthetsa kuopseza akazi ndi ana. Pakati kwenikweni kusonyeza lopuma, chiletso zolimbitsa thupi, ndi m'chipatala. Zovuta mankhwala osankhidwa makamaka payekha ndipo malingana ndi magazi anayamba zimene yaitali. Kuteteza, mankhwala ndi aligorivimu a kukha mwazi obstetric anayamba ndi unduna wa zaumoyo ndipo ayenera kulemekeza ndi madokotala pamene wodwala atafika kuchipatala.

Ngati pali magazi mu prescribers oyambirira mimba utithandize magazi kukhuthala, mankhwala ndi kulimbitsa wothandizira. Pankhani ya chikhalidwe kwambiri mkazi ndi mwana wosabadwayo amasonyeza kwambiri. Pamaso pa wachitatu magazi trimester limasonyeza ntchito yobereka. Ngati mukukumana ndi postpartum obstetric kukha mwazi wa protocol chithandizo angakhale osiyana - kugwiritsa ntchito mankhwala ndi kuchotsa chiberekero. Izi zidalira pa zovuta vuto, chifukwa chinthu chofunika kwambiri - kupulumutsa moyo wa mkazi.

prophylaxis

Kupewa kutaya kwa magazi obstetric yochepa kuti kugwilizana ndi mfundo zingapo zofunika. Choyamba, muyenera kukonzekera mimba m'nthawi yake kulembetsa ndi kukaonana ndi adokotala zonse. Kuyenera likupezeka nthawi kuchiza matenda a kumaliseche. Ngati ndi kotheka, muyenera kunyamula kuipidwa wa physiotherapy. Mu ndondomeko ya kubereka zinthu molondola, kutenga nkhani ya malangizo onse a dokotala, komanso kuonanso bwino zizindikiro ndi contraindications.

Kuteteza zosayembekezereka wa magazi mu nyengo ya postpartum, muyenera kutsatira malamulo awa:

• kuyamwitsa pa kufunika;
• kuyan'ana chikhodzodzo;
• kwala m'mimba mwake;
• kugwiritsa ozizira pamimba m'munsi.

zonsezi onse njira chingatithandize kupewa pakutchulidwa magazi ndi kusintha umoyo wa akazi.

Zovuta ndi sequelae magazi

Kungakhale mavuto oopsa kwambiri ndi zotsatira za magazi. Kuti zinthu monga:

• Yoopsa hypoxia;
• yoopsa imfa;
• kukha mwazi khoma mkati mwa chiberekero;
• hemorrhagic mantha;
• mayi wake atamwalira.

Komanso, mavuto monga matenda aakulu a coagulation magazi kupanga kuchuluka thrombi ndi pakutchulidwa magazi. Zingakhalenso kupanda kotunga magazi, kusokoneza chitetezo cha endocrine ndi kupanda kupanga timadzi.